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General NPI Number Information
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NPI Number | 1932746948
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Entity Type | Individual
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Provider Name | ANGELICA GRACE FALCINELLI LCSW, LCAT, BC-DMT
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Gender | Female
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Dates
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Enumeration Date | 12/09/2019
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1051 RIVERSIDE DR
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City | NEW YORK
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State | NY
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Zip | 10032-1007
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Country | US
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Telephone | 646-774-8573
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Fax | 646-774-8572
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Provider Business Mailing Address
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Address Line | 600 W 169TH ST APT 66
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City | NEW YORK
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State | NY
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Zip | 10032-2910
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Country | US
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Telephone | 718-301-4510
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 111308
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number | 002214
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 097380
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License Number State | NY
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